Medial Osteoectomy as a Routine Procedure in Rhinoplasty: Six-Year Experience with an Innovative Technique

Aesthetic Plast Surg. 2018 Feb;42(1):256-263. doi: 10.1007/s00266-017-0954-4. Epub 2017 Aug 4.

Abstract

Background: Medial osteotomy is an integral part of most rhinoplasty procedures, and when improperly performed, it is associated with postoperative complications and nasal contour deformities. In this article, we present a minimally traumatic and easy-to-perform medial osteoectomy technique with a pair of pliers, as a routine procedure, instead of the traditional medial osteotomy with osteotome and hammer. We report our experience with the use of the technique in a series of rhinoplasty procedures and review in brief the existing literature.

Methods: One hundred and thirty-five patients underwent rhinoplasty operations to correct aesthetic nose deformities, with the use of the suggested surgical technique. Two different types of medial osteoectomy, performed with the pliers, were used: Type I for dorsal nasal hump reduction and slight narrowing of the nose and type II for the management of a wide nasal dorsum along with or without hump removal.

Results: Postoperative results were favorable, by both clinical examination and comparison of preoperative and postoperative photographs, in 98.5% of patients. Only two patients with wide nasal dorsums had inadequate narrowing of their broad nose and underwent successful revision surgery.

Conclusions: The suggested technique is easy to perform, has a short learning curve, provides high accuracy over the location and amount of the nasal bone to be removed, but inflicts minimal trauma. As a result of the aforementioned advantages, the risk of postoperative complications is low, and most importantly, reliable, consistent, and aesthetically pleasing results are easily ensured.

Level of evidence iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Keywords: Medial osteoectomy; Medial osteotomy; Rhinoplasty.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Esthetics
  • Female
  • Follow-Up Studies
  • Greece
  • Humans
  • Male
  • Middle Aged
  • Nasal Bone / surgery*
  • Nose / abnormalities
  • Nose / surgery*
  • Osteotomy / instrumentation
  • Osteotomy / methods*
  • Retrospective Studies
  • Rhinoplasty / classification
  • Rhinoplasty / methods*
  • Surgical Instruments*
  • Treatment Outcome
  • Young Adult